Treatments and Severe Outcomes for Patients Diagnosed With MIS-C at Four Children's Hospitals in the United States, March 16, 2020-March 10, 2021
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved..
BACKGROUND: Clinical management of multisystem inflammatory syndrome in children (MIS-C) has varied over time and by medical institution.
METHODS: Data on patients with MIS-C were collected from 4 children's hospitals between March 16, 2020 and March 10, 2021. Relationships between MIS-C treatments and patient demographics, clinical characteristics, and outcomes were described. Propensity score matching was utilized to assess the relative risk of outcomes dependent on early treatment with intravenous immunoglobulin (IVIG) or low-dose steroids, controlling for potential confounding variables.
RESULTS: Of 233 patients diagnosed with MIS-C, the most commonly administered treatments were steroids (88.4%), aspirin (81.1%), IVIG (77.7%) and anticoagulants (71.2%). Compared with those patients without respiratory features, patients with respiratory features were less likely to receive IVIG and steroids on the same day (combination treatment) (44.1%). Controlling for confounding variables, patients receiving IVIG within 1 day of hospitalization were less likely to have hospital length of stay ≥8 days (RR = 0.53, 95% CI: 0.31-0.88). Patients receiving low-dose steroids within 1 day of hospitalization were less likely to develop ventricular dysfunction (RR = 0.45, 95% CI: 0.26-0.77), have increasingly elevated troponin levels (RR = 0.55, 95% CI: 0.40-0.75) or have hospital length of stay ≥8 days (RR = 0.46, 95% CI: 0.29-0.74).
CONCLUSION: Treatments for MIS-C differed by hospital, patient characteristics and illness severity. When IVIG and low-dose steroids were administered in combination or low-dose steroids were administered alone within 1 day of hospitalization, the risk of subsequent severe outcomes was decreased.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
The Pediatric infectious disease journal - 42(2023), 11 vom: 01. Nov., Seite 990-998 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Shah, Ami B [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 01.11.2023 Date Revised 01.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/INF.0000000000004065 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363550437 |
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| 100 | 1 | |a Shah, Ami B |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Treatments and Severe Outcomes for Patients Diagnosed With MIS-C at Four Children's Hospitals in the United States, March 16, 2020-March 10, 2021 |
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| 500 | |a Date Revised 01.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Clinical management of multisystem inflammatory syndrome in children (MIS-C) has varied over time and by medical institution | ||
| 520 | |a METHODS: Data on patients with MIS-C were collected from 4 children's hospitals between March 16, 2020 and March 10, 2021. Relationships between MIS-C treatments and patient demographics, clinical characteristics, and outcomes were described. Propensity score matching was utilized to assess the relative risk of outcomes dependent on early treatment with intravenous immunoglobulin (IVIG) or low-dose steroids, controlling for potential confounding variables | ||
| 520 | |a RESULTS: Of 233 patients diagnosed with MIS-C, the most commonly administered treatments were steroids (88.4%), aspirin (81.1%), IVIG (77.7%) and anticoagulants (71.2%). Compared with those patients without respiratory features, patients with respiratory features were less likely to receive IVIG and steroids on the same day (combination treatment) (44.1%). Controlling for confounding variables, patients receiving IVIG within 1 day of hospitalization were less likely to have hospital length of stay ≥8 days (RR = 0.53, 95% CI: 0.31-0.88). Patients receiving low-dose steroids within 1 day of hospitalization were less likely to develop ventricular dysfunction (RR = 0.45, 95% CI: 0.26-0.77), have increasingly elevated troponin levels (RR = 0.55, 95% CI: 0.40-0.75) or have hospital length of stay ≥8 days (RR = 0.46, 95% CI: 0.29-0.74) | ||
| 520 | |a CONCLUSION: Treatments for MIS-C differed by hospital, patient characteristics and illness severity. When IVIG and low-dose steroids were administered in combination or low-dose steroids were administered alone within 1 day of hospitalization, the risk of subsequent severe outcomes was decreased | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Immunoglobulins, Intravenous |2 NLM | |
| 650 | 7 | |a Steroids |2 NLM | |
| 700 | 1 | |a Abrams, Joseph Y |e verfasserin |4 aut | |
| 700 | 1 | |a Godfred-Cato, Shana |e verfasserin |4 aut | |
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| 700 | 1 | |a Hammett, Teresa A |e verfasserin |4 aut | |
| 700 | 1 | |a Perez, Maria A |e verfasserin |4 aut | |
| 700 | 1 | |a Hsiao, Hui-Mien |e verfasserin |4 aut | |
| 700 | 1 | |a Baida, Nadine |e verfasserin |4 aut | |
| 700 | 1 | |a Rostad, Christina A |e verfasserin |4 aut | |
| 700 | 1 | |a Ballan, Wassim |e verfasserin |4 aut | |
| 700 | 1 | |a Ede, Kaleo |e verfasserin |4 aut | |
| 700 | 1 | |a Laham, Federico R |e verfasserin |4 aut | |
| 700 | 1 | |a Kao, Carol M |e verfasserin |4 aut | |
| 700 | 1 | |a Oster, Matthew E |e verfasserin |4 aut | |
| 700 | 1 | |a Belay, Ermias D |e verfasserin |4 aut | |
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